title: Clinical and laboratory characteristics of penicilliosis marneffei among patients with and without HIV infection in Northern Thailand: a retrospective study.
abstract: BACKGROUND
  Penicilliosis marneffei is increasingly observed in individuals without HIV infection. This study aimed to compare the clinical and laboratory features among HIV infected and uninfected individuals with penicilliosis marneffei.
  
  
  METHODS
  A retrospective cohort study was conducted between January 1, 2007 and December 31, 2011 at Chiang Mai University Hospital. We included individuals who were ≥15 years of age and presented with culture-proven P. marneffei infection.
  
  
  RESULTS
  116 HIV-infected and 34 HIV-uninfected patients were enrolled. Comparing to HIV-infected patients, HIV-uninfected patients were older; less likely to have fever, splenomegaly, and umbilicated skin lesions; more likely to have Sweet's syndrome and bone and joint infections; had higher white blood cell count, platelet count, and CD4 cell count; had lower alanine transaminase (ALT); and less likely to have positive fungal blood cultures. The mortality rates were 20.7% and 29.4% among HIV infected and uninfected patients, respectively.
  
  
  CONCLUSIONS
  Clinical manifestations of penicilliosis marneffei are different between patients with and without HIV infection. Physician's awareness of this disease in HIV-uninfected patients may prompt the diagnosis and timely treatment, and can lead to a better outcome.
authors.affiliation: Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. rchaiwar@gmail.com.
authors.forename: Rathakarn
authors.initials: R
authors.lastname: Kawila
authors.forename: Romanee
authors.initials: R
authors.lastname: Chaiwarith
authors.forename: Khuanchai
authors.initials: K
authors.lastname: Supparatpinyo
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D010407:Penicillium / Q000235:genetics / Q000302:isolation & purification*; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents